This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2251722 Blue Cross of Idaho (BCI) is seeking an experienced Director, Enrollment and Billing to oversee member enrollment and billing activities. This leadership role will develop strategies, implement process improvements, ensure regulatory compliance, and champion quality excellence. The Director will evaluate enrollment and billing performance, enhance the customer experience, and drive operational efficiency. The ideal candidate will find opportunities for improvement, develop and implement solution plans, coach team members, and achieve key performance metrics. Reporting to the VP, Business Operations, this role will work onsite in Meridian Idaho. #LI-Onsite

Key Responsibilities:

• Strategic Leadership: Develop and implement strategies for enrollment and billing operations. Lead initiatives to improve process efficiency and quality standards.

• Performance Evaluation: Establish and maintain systems to evaluate the performance of enrollment and billing processes. Monitor key metrics to ensure objectives are met.

• Regulatory Compliance: Ensure all activities align with relevant federal, state, and local regulations, including Medicare and CMS requirements.

• Customer Experience: Enhance the member experience by implementing customer-focused improvements and monitoring Net Promoter Scores (NPS).

• Team Management: Lead, coach, and develop the enrollment and billing team. Promote a positive and inclusive work environment.

• Financial Oversight: Prepare and manage the department\'s budget, ensuring expenditures align with approved budgets. Implement cost-saving measures where applicable.

• Collaboration and Communication: Work closely with other departments and business partners to ensure effective communication and collaboration. Report significant issues and events to senior management.

• Policy Development: Develop and maintain departmental policies and procedures that support company goals and regulatory requirements.

• Training and Development: Direct the design and implementation of training programs and computer-based training, to enhance team skills and knowledge. Evaluate the effectiveness of training initiatives.

To be considered for this opportunity you have:

• Experience: Ten (10) years\' experience in health insurance industry or healthcare revenue services to include management experience

• Education: Bachelor\'s Degree in Quantitative field, Business, or Healthcare Administration preferred; or equivalent work experience (Two years\' relevant work experience is equivalent to one-year college)

We\'d also love it if you had:

• MBA
• Regulatory Experience
• Claims and/or Customer Service Experience
• Experience in the healthcare industry

Knowledge, Skills and Abilities (KSAs) needed in this role:

Knowledge of:

• Leadership development and coaching concepts
• Facets Claims Processing System
• Benefit Focus or other enrollment tools
• Medicare and CMS regulatory requirements
• Member Billing and Broker Commission
• Budgeting and basic accounting principles
• Business development and presentations
• Lean six sigma concepts
• Customer Service and Net Promoter Scoring
• Quality assurance approaches and development of Key Performance Indicators and business analytics
• Components and principles of management production control and data processing management information systems that affect claims processing
• Accounting principles, business budgeting processes, forecasting and planning techniques
• Health insurance contract benefits and provisions and healthcare billing poli ies
• Ability to develop and maintain effective working relationships at all levels

Skills:

• Strong collaboration and business insight
• Strong people leadership experience
• Excellent verbal and written communication
• Excellent motivational and staff recognition

Here\'s what your day may look like:

Assure cost effective high service levels to members and providers through fair, accurate, consistent and timely enrollment/eligibility processing.

Assure that national and corporate standards are met for timeliness and accuracy in enrollment processing. Participate in the establishment and negotiation of performance guarantee standards for large group accounts. Ensure these standards are met for areas under Director\'s purview.

Represent Enrollment and Billing operational perspective in a productive manner and participate in the debate/analysis of the pros and cons of the issues when corporate business rules are developed.

Assure eff